COMPLEX CARE PROGRAM EXTENDS YOUR REACH FOR BETTER HEALTH
The Complex Care Program (CCP) is designed to address the needs of the top 15% of health care utilizers. CCP is a care program that allows our nurse practitioners to collaborate with Primary Care Physicians (PCPs) and extend care to a patient's home. The nurse practitioners provide in-home care based on the medical directives of the PCP.
Patient Qualifications for CCP
Patients are identified for CCP by the health plan. The patient's PCP makes the final decision on whether or not to refer the patient to the CCP program. Our health care professionals will then consult with the PCP to determine an appropriate care plan that includes in-home care services. Patients who qualify for CCP generally have more than 2 hospitalizations and/or more than 3 emergency room visits in the year prior to referral. The members are chronically ill with multiple uncontrolled comorbidities including:
- Heart Failure (CHF)
- Chronic Obstructive Pulmonary Disease (COPD)
- Chronic Kidney Disease
- Diabetes Mellitus
- Coronary Artery Disease
What Physicians need to know if their Patient is enrolled in CCP
- You will remain as the patient's primary doctor. The Alegis Care CCP program provides in-home care support for patients, which can be helpful for patients that have difficulty getting to your office. Our providers follow the care plan developed by you.
- Patients will receive personalized in-home care. Our providers will assist you with specific medical care and decisions -- from providing medications and equipment to conducting preventive screenings and exams. Most of your patient's care will take place in the comfort of their own home instead of a medical center or doctor office.
- Patients have a full support team. Our doctors, nurse practitioners, and medical assistants (telephonic support team) work with many other local community resources to meet all of your medical care needs.
How physicians benefit from the Complex Care Program:
- Additional support for your most complex and high utilizing patient cases – results in more time for you to devote to other patients
- Extends your care reach to inside the home
- Improved health outcomes for your patients
- Increased quality/ HEDIS measures
- Improved Medical Loss Ratio and P4Q measures – leads to financial benefits for physicians